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07/29/2008- Five years ago, I developed duodenal ulcers after taking Fosamax for six weeks. I was also taking ibuprofen for headaches at the same time.

Last year, after taking baby aspirin for a few months, I had an endoscopy, which revealed more ulcers. I was diagnosed with H. pylori and treated with antibiotics.

I have bad osteoarthritis pain in my right knee and hip and would love to take ibuprofen instead of Tylenol, but I don't want to take omeprazole long term and don't want to risk another ulcer.

Since the H. pylori is gone, could I risk the ibuprofen? Or is there some other agent I could take that would relieve the pain without causing ulcers?



The combination of Fosamax with the nonsteroidal anti-inflammatory drug (NSAID) ibuprofen was a prescription for trouble.

Both medications can cause ulcers. A study of Fosamax together with a different NSAID, naproxen, showed that ulcers were more likely in women taking both medicines (Archives of Internal Medicine, Jan. 8, 2001).

A Helicobacter pylori (H. pylori) stomach infection increases the risk of ulcers. Even without H. pylori, you might be susceptible to ulcers if you take aspirin or an NSAID.

Ask your doctor about either Disalcid or Trilisate, anti-inflammatory drugs that are less likely to cause stomach irritation.

Reach Joe Graedon, a pharmacologist, and Teresa Graedon, an expert in medical anthropology and nutrition, at www.peoplespharmacy.com or in care of this newspaper.